1University of Ioannina, 1st Division of Internal Medicine and Hepato-Gastroenterology Unit, Ioannina, Greece; 2Tufts University School of Medicine and Institute for Clinical Research and Health Policy Studies, Department of Medicine, Boston, United States; 3Medical School, University of Ioannina, Division of Dermatology, Ioannina, Greece

Background: Data concerning the dermatological surveillance of inflammatory bowel disease (IBD) patients treated with biological therapy agents are limited. The aim of this study was the detailed dermatological examination and the creation of a dermatological surveillance program in patients with inflammatory bowel disease (IBD) treated with biological therapy agents.

Methods: During the years 20092010, 84 examinations took place in 55 patients (33 male, 29 Crohn's disease) treated with Infliximab (37) or Adalimumab (18). Demographic characteristics, disease characteristics and treatment, special physical characteristics like skin or eye colour, habits like smoking and exposure to harmful solar radiation, skin's status, presence or history of sun burns, presence of specific skin lesions like nevi and their number as well as skin elastosis, scabs and hyperkeratoses were documented.

Results: Thirty-seven out of 55 patients (67.5%) had medium skin colour 38 had dark eye colour (69.1%), while 17 were smokers (30.9%). In total, 24 patients (43.6%) reported maximally 4 cases of sun-burn and 10 patients had more than 5 sun-burns (18.2%), while 28 patients were working only outdoors (50.9%). Fourteen patients (25.5%) were found to have 1 nevus, 10 (18.2%) had 2 nevi and 23 (41.8%) 3 or more. In addition, 45 patients (81.8%) did not have any hyperkeratoses, 8 (14.5%) had 1 and 2 patients had 2 or more. One case of basal cell carcinoma was diagnosed in one female patient and was successfully surgically removed.

Conclusions: Patients with IBD should be routinely monitored with dermatological examinations aiming to detect skin lesions at an early stage in order to observe them and treat them as needed.